Case Sharing | Left flexible ureteroscopic lithotripsy

 

  

Professor Huo Shaojun

Chief Physician

Department of Urologic Surgery II, Handan Central Hospital

Director of Society of Urologic Surgery, Handan Medical Association

Standing Committee Member of Society of Urologic Surgery, Hebei Medical Doctor Association

Committee Member of Society of Urologic Surgery, Hebei Medical Association

 

Case Overview

Flexible ureteroscopic lithotripsy

(Single-use Ureteroscope)

Basic information

• Male, 61 years old

• Chief complaint (CC): Left upper ureteral calculi discovered during physical examination

• Color Doppler ultrasound in an extramural hospital (2023-02-27): Multiple hyperechoic shadows visible in the left kidney, the upper segment of the left ureter shows dilation of approximately 9.4 cm with an internal strong hyperechoic shadow measuring approximately 15.9 × 8.4 mm

• CT: (2023-03-13)

 

 

• Diagnosis: A stone in the upper segment of the left ureter

 

Treatment Process

• Surgical procedure: Left flexible ureteroscopic lithotripsy

• Surgical process:

1. After anesthesia, the patient was placed in the lithotomy position, and the surgical area was sterilized and draped. Next, a flexible ureteroscope was inserted to visualize the bladder and the openings of bilateral ureters.

2. A guidewire was inserted into the left ureter, and the ureteroscope was advanced along the guidewire, revealing a stone in the upper segment of the ureter.

3. A ureteral access sheath (UAS) was inserted along the guidewire, followed by the insertion of an electronic flexible ureteroscope to visualize the upper, middle and lower calyces of the kidney.

 

 

4. After observation of the stone, it was broken down into powder using holmium laser lithotripsy, and the condition of the calyces was assessed.

 

 

 

 

5. A stone retrieval basket was used to retrieve larger fragments of the stone.

6. The ureteroscope was withdrawn, and a double-J stent was placed.